Pronóstico del retratamiento de conductos no quirúrgico

PRONÓSTICO DEL RETRATAMIENTO DE CONDUCTOS NO QUIRÚRGICO El tratamiento de conductos es un procedimiento conservador que tiene un alto porcentaje de éxito a largo plazo. Sin embargo, algunos dientes endodonciados presentan patología periapical y los signos y síntomas del paciente no desaparecen después del tratamiento. El retratamiento de conductos no quirúrgico trata las patologías asociadas al fracaso endodóntico, y en algunos casos está indicado con fines restauradores (23). Consiste en la eliminación del material intraconducto, la detección de deficiencias, y la reparación de los defectos patológicos o iatrogénicos, seguido de la instrumentación y limpieza y la obturación final de los conductos. Los objetivos del estudio fueron: 1) determinar el pronóstico del retratamiento. 2) Relacionar el pronóstico del retratamiento dental con: la edad y el sexo; Si se ha respetado la anatomía del conducto o no; la presencia o no de lesiones apicales y su tamaño; el contenido previo en el interior del conducto y su extensión; el grupo dentario; y 3) evaluar el porcentaje de supervivencia después del retratamiento de conductos. Se incluyeron en el estudio todos los pacientes sometidos a retratamiento no quirúrgico desde enero de 2012 a marzo de 2015. Todas las intervenciones fueron realizadas por alumnos del 2º curso del Master de Odontología Restauradora y Endodoncia. Los alumnos trabajaron con microscopía operatoria, siguiendo un mismo protocolo de retratamiento para todos los casos. Los dientes se clasificaron según su grupo dental y según la presencia o ausencia de lesión radiotransparente apical al inicio del tratamiento. También se empleó una modificación de la clasificación de Gorni y cols., que distingue las causas que provocaron el fracaso del tratamiento inicial en función de si se conservó o no la anatomía original del conducto radicular. El éxito global del retratamiento de conductos fue del 87,4%. Se observó curación completa en el 62,7% de los dientes y curación incompleta en el 24,7%. Siendo la supervivencia del 90,4%.PROGNOSIS OF NON SURGICAL ROOT CANAL RETREATMENT Nonsurgical canal retreatment is a conservative procedure that has a high percentage of long-term success. However, some endodontic teeth have periapical pathology and the patient's signs and symptoms do not disappear after treatment. Non-surgical duct retreatment treats pathologies associated with endodontic failure, and in some cases is indicated for restorative purposes (23). It consists on the elimination of the intraconduct material, the detection of deficiencies, and the repair of the pathological or iatrogenic defects, followed by the instrumentation and cleaning and the final filling of the roots. The objectives of the study were: 1) to determine the prognosis of retreatment. 2) Relate the prognosis of dental retreatment with: age and sex; Whether the anatomy of the root has been respected or not; the presence or absence of apical lesions and their size; the previous contents inside the duct and its extension; the dental group; and 3) to evaluate the percentage of survival after retreatment of ducts. All patients undergoing nonsurgical retreatment from January 2012 to March 2015 were included in the study. All interventions were performed by students of the 2nd year of the Master of Restorative Dentistry and Endodontics. The students worked with operative microscopy, following the same protocol of retreatment for all the cases. The teeth were classified according to their dental group and according to the presence or absence of apical radiolucent lesion at the beginning of treatment. A classification modification by Gorni et al. Was also used, which distinguishes the causes that caused the failure of the initial treatment, depending on whether or not the original anatomy of the root canal was preserved. The overall success of root canal retreatment was 87.4%. Complete healing was observed in 62.7% of the teeth and incomplete healing in 24.7%. Being the survival of 90.4%

Probiotic treatment in the oral cavity : an update

Probiotics have been found to be beneficial to host health. Their primary use in medicine has been for the management of intestinal tract problems. In recent years, probiotics have been used as a treatment to promote oral health. The aim of the present study was to review published studies regarding probiotics and their effects on the oral cavity. Studies reporting the anticariogenic effects of probiotics, their use in the treatment of periodontal disease, a reduced crevicular fluid volume and cytokine content, as well as their use in the treatment of halitosis and Candida albicans were identified. Studies assessing residence time of probiotics in the oral cavity were also selected for retrieval. Most authors concluded that the use of oral probiotics was associated with an improvement in oral health, including a significantly reduced level of cariogenic and periodontal pathogens and a lower crevicular fluid volume and cytokine concentration

An in vitro comparison of cyclic fatigue resistance of ProTaper universal and GT series X files

Objective : The aim of this study was to compare the cyclic fatigue resistance of two nickel-titanium (NiTi) endodontic instruments from ProTaper and GT series X files. Study Design: Cyclic fatigue test was realized with instruments from ProTaper: F1 and F3 (Denstply Maillefer, Ballaigues, Switzerland) and GT-X: 20.06 and 30.08 (Dentsply Tulsa Dental, Tulsa, Oklahoma, United States of America). A total of 320 instruments were rotated in 4 curved artificial canals with different angles and radius of curvature. The time and cycles to failure were calculated. The data was compared using a Mann-Whitney, Kruskall-Wallis, and Kolmogorov-Smirnov tests, with a significance level of p<0.05. Results: GT-X files rotated for a significantly longer period of time before separation occurred, thus GT-X files where more resistant to the cyclic fatigue compared with ProTaper. Conclusion : GT-X files have a greater resistance to cyclic fatigue, this fact can be caused by the use of the Ni-Ti alloy "M-Wire"

Survival of implants placed with the osteotome technique : an update. Review

A literature review is made to analyze the survival of implants placed with the osteotome technique. A PubMed search was made based on the key words ?osteotome AND dental implants?, corresponding to publications between 1998-2008. Th e inclusion criteria were: a) a minimum of 10 patients; b) a minimum follow-up of 6 months; c) implants placed using the osteotome technique with or without indirect sinus lift; and d) specification of the implant number and survival rate. Sixty-four articles were identified, of which 20 met the inclusion criteria. A total of 2006 implants were placed in 1312 patients using the osteotome technique. Th e duration of follow-up after prosthetic loading ranged from 6-144 months. Indirect sinus lift was carried out in all but one of the studies. Th e residual crest height ranged from 2.3-11.7 mm. with a mean gain in bone after sinus lift of 2.5-5.5 mm. Th e time from implant placement to prosthetic loading varied from 1.5-9 months. Th e percentage implant survival rate was 90.5-100%. Th e survival rate of implants placed with the osteotome technique is high and does not differ with respect to implant placement with the conventional techniqu

Radiographic technical quality of root canal treatment performed ex vivo by dental students at Valencia University Medical and Dental School, Spain

performed on extracted teeth by undergraduate dental students. Study Design: A total of 561 premolars and molars extracted teeth were prepared using nickel-titanium rotary files or manual instrumentation and filled with gutta-percha using a cold lateral condensation technique, by 4th grade undergraduate students. Periapical radiographs were used to assess the technical quality of the root canal filling, evaluating three variables: length, density and taper. These data were recorded, scored and used to study the "technical success rate" and the "overall score". The length of each root canal filling was classified as acceptable, short and overfilled, based on their relationship with the radiographic apex. Density and taper of filling were evaluated based on the presence of voids and the uniform tapering of the filling, respectively. Statistical analysis was used to evaluate the quality of root canal treatment, considering p < 0.05 as a statistical significant level. Results: The percentage of technical success was 44% and the overall score was 7.8 out of 10. Technical success and overall score were greater with rotary instruments (52% against 28% with a manual one, p < 0.001; 8.3 against 6.7 respectively, p < 0.001). Conclusions: It appears that inexperienced operators perform better root canal treatment (RCT) with the use of rotary instrumentation

Treatment of multiple traumatized anterior teeth associated with an alveolar bone fracture in a 20-year-old patient: a 3-year follow up

Intrusive luxation is a type of recognizable luxation injury represented by a deeper axial displacement of the tooth toward the alveolar bone. Treatment strategies include waiting for the tooth to return to its position, immediate surgical repositioning, and repositioning through dental traction by orthodontic devices. The aim of this case report was to present the management of severe dental trauma and later restoration following IADT. A 20-year-old patient was presented after fainting at home four hours before, resulting in a dento-alveolar trauma. Clinical examinations revealed a traumatic intrusion, in 1.2, 1.1 and 2.1, uncomplicated crown fractures in 1.1 and 2.1 and a complicated crown-root fracture in 2.2. The diagnosis was confirmed with CBCT. Following IADT protocol, the emergency treatment consisted of the surgical repositioning and semi-rigid splinting using orthodontic wire-composite, repla - cing the buccal bone plate, and postoperative instructions to the patient regarding oral hygiene. After 2 weeks the root canal treated and filled with fiberglass posts in 1.2, 1.1, 2.1 and 2.2. Splint was removed after 4 weeks and the IADT reassessment protocol followed, with revisions at 6-8 weeks, 6 months, a year and annual reviews for 5 years. A year after the treatment, the traumatized teeth were restored with minimally invasive preparations of feldspathic ceramic. Esthetics and function were recorded with a 3-year follow-up period

Traumatic dental injuries among schoolchildren in Valencia, Spain

Aim: The aim of the present study was to identify some factors related to the occurrence of dental trauma in mixed and permanent dentition. Design of the study: Over a period of two months 1325, 6 to 18 year olds from three primary schools in Valencia were examined. Data was collected through clinical examinations and interviews and their Dental trauma was classified according to IADT´s criteria. Results: The prevalence of dental injuries was 6%; boys aged between 12-18 years old experienced more injuries than girls. There was a statistical difference between the types of fractures. Non complicated coronal fractures were the most frequent (9.18%). Games were the main cause of trauma (40%) in both sexes. In 14.3% of patients a dental colour change was observed. Angle´s class I was the most frequent in traumatized injured children (41.2%). Conclusions: The present study revealed a relatively low prevalence of dental trauma, but this figure still represents a large number of children. Therefore, educational programs are to be initiated for the community regarding causes , prevention and treatments of traumatic dental injuries

An in vitro cyclic fatigue resistance comparison of conventional and new generation nickel-titanium rotary files

New designs and processing of Niquel-Titanium (NiTi) have been introduced to increase resistance to cyclic fatigue. The purpose of this study was to compare the cyclic fatigue resistance of 3 NiTi rotary instruments, ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland), Profile Vortex Blue (PVB; Dentsply Tulsa Dental, Tulsa, OK, USA) and ProTaper Universal (PTU; Dentsply Maillefer, Ballaigues, Switzerland). A cyclic fatigue test was conducted operating instruments from ProTaper Next X2, Profile Vortex Blue 25.06 and ProTaper F2. A total of 234 instruments were rotated in 2 simulated stainless steel curved canals with different angles of curvature (45º and 60°) and 5-mm radius of curvature. The number of cycles to fracture (NCF) was calculated. Data were compared using 2-way analysis of variance and post-hoc Bonferroni test in software (SPSS 15.0, Chicago, IL). Statistical significance was set at P<0.05. Profile Vortex Blue showed higher resistance to cyclic fatigue in both curved canals than ProTaper Next and ProTaper Universal (P<0.001). ProTaper Universal obtained the lowest resistance to cyclic fatigue in both canals (P<0.001). Profile Vortex Blue was the most resistant to cyclic fatigue failure, followed by ProTaper Next and ProTaper Universal. Anatomical complexity (angle of curvature) and manufacturing process of NiTi are important factors for resistance to cyclic fatigue

Measurement of the percentage of root filling in oval-shaped canals obturated with Thermafil Obturators and Beefill 2in1: in vitro study

Background: The aim of the study was to measure the percentage of root canal fillings in long oval canals obturated with thermoplasticized gutta-percha techniques, Beefill 2in1® and Thermafil Obturators®. Material and Methods: Fifty four mandibular incisors were selected after bucco-lingual and mesio-distal radiographs showed at 5 mm from apex an internal long: short diameter ≥2. Teeth were instrumented with Protaper Universal and divided in two groups of 27. Group 1 was obturated with Thermafil Obturators® and group 2 with Beefill 2in1®. Two horizontal sections were cut at 5 and 7 mm from the apex and photographed in a stereo-microscope. The total area of the canal and filled canal in cross-sections were measured with AutoCad and the percentages of gutta-percha-sealer and voids in the canal were obtained. Results: Both systems achieved high percentage of filled canal, Thermafil 96.8% and Beefill 2in1 98.9%. The percentages of voids in both groups were very low. No significant differences were found between the two groups. The percentage obtained at 5 and 7 mm from the apex in both groups showed no significant dif ference. Conclusions: The percentages of filled canal (gutta-percha-sealer) were high and these two thermoplasticized techniques are suitable for long oval canals obturation

Interleukins IL-6, IL-8, IL-10, IL-12 and periimplant disease. An update

Introduction: A study is made of the usefulness of cytokines (such as interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and interleukin-12 (IL-12)) as markers of periimplant disease (mucositis and periimplantitis). An increase in the levels of these cytokines in dental implant crevicular fluid may give rise to a lack of osteointegration, bbone loss or implant failure. Obbjective: To review the literature relating IL-6, IL-8, IL-10 and IL-12 levels to dental implant surgery and periimplantitis. Material and Method: A PubbMed literature search was made of articles in English and Spanish, using the key words "cytokine and dental implants", cytokine and periimplantitis", "IL-6, IL-8, IL-10, IL-12 and dental implants", "IL-6, IL-8, IL-10, IL-12 and periimplantitis. Fourteen articles were found and classified into two groups relating interleukin levels to: a) periimplant disease; and b) their influence upon dental implant osteointegration without periimplant disease. Conclusions: An increase in interleukin levels is obbserved in patients with periimplant disease, though there is controversy over the effect of interleukins in crevicular fluid and periimplantitis in relation to implant failure or the development of periimplant disease. © Medicina Oral S. L